Modelling Home Care Services to Identify Service Shortfalls

Transcription

1 Modelling Home Care Services to Identify Service Shortfalls Carmen Hust, R.N. Comcare Health Services 311 O Connor, Ottawa ON. K2P 2G chust@monisys.ca Eric Milligan, Delsys Research Group Suite Rideau St. Ottawa, ON. K1N 5W8 Canada milligan@delsysresearch.com Gordon Kubanek, Brookfield High School 824 Brookfield Ottawa ON. K1V 6J gordon_kubanek@ocdsb.edu.on.ca

2 Project Goal A model was built to help understand and communicate with other players in the Health sector the reasons why Home Care Employers are having difficulty hiring and retaining workers. The model may also serve for future planning that could prevent a severe shortfall in services as the population ages and hospitals discharge patients whose conditions are more complex.

3 Problem Statement The ageing population and shorter hospital stays require more Home Care Services. As more home care services are required the ability of service providers to meet service needs by hiring and retaining more workers becomes increasingly difficult. The more training workers receive the more able they are to seek better paying employment opportunities.

4 Key Variables Number of available Home Care providers for hire Number of Home Care clients requiring services Gap in Services delivered wage gap between home care and other jobs recruitment & retention rate job satisfaction & stress complexity of services required relative attractiveness of home care

5 Behavior Over Time Graphs Number of available Home Care providers for hire Number of Home Care clients requiring services months 12 months 12

6 Behavior Over Time Graphs job stress complexity of services required months 12 months 12

7 Behavior Over Time Graphs wage gap between home care and other jobs relative attractiveness of home care months 12 months 12

8 Causal Loops: Feedback stress worker productivity - - care delivery gap service hours per client wage gap - alternative employment opportunities quitting rate wage rate corresponding to skill level ability of home care worker to move into other higher paying health care jobs Productivity - of Home Care Agency - home care delivery entitlement ability to increase wages skill level of employee Global Home Care Budget investment in training complexity of services required skill level of employee required

9 HomeCare Service Provider ` Policy Structure Diagram availability of alternate employment more workers available pool of available homecare workers Effect of Worker Stress on Worker Productivity stress providing services care delivery gap Care Delivery Gap Reduces Assessed HomeCare Entitlement demanding services Adjusted Service Hours per Client workers find other jobs Hiring Delay job satisfaction hiring HomeCare Workers quitting Complexity of Required Home Care Services demand for Long Term Care Workers Effect of Wage Gap on Hiring Ä wages paid by other health care sectors Wage Gap Effect of Wage Gap on Quitting Ä leaving homecare HomeCare Clients clients from Hospitals demand for Hospital workers direct referrals <Time> Fraction of Population requiring Health Care Services

10 Leverage points Identified The following stresses were identified as requiring attention by Home Health Care providers: wage gap between Home Care workers & others productivity of Home Care workers skill level of Home Care workers competition between Home Care Providers & Long Term Care Facilities for the same workers demographic shifts will continue to increase the fraction of the population requiring Home Care services global Home Care budget

11 Recommended Interventions wages need to correspond to skill level do not reduce the time per visit to a point where the worker spends much of her/his time travelling between clients coordinate hiring and training requirement with Long Term Care facilities & Hospitals increased efficiencies using new technologies & management methods are needed to allow fewer workers to meet the needs of more clients the Home Care Budget needs to reflect the demographic population shifts

12 Conclusion The use of Systems Thinking tools will improve communication between the Health Care sectors It is hoped this investigation of the interrelationships and feedback processes will allow local Health Care Policy makers deal with stresses on the System